Navigating Radiology: Safe Imaging During Pregnancy

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Imaging during pregnancy is sometimes necessary to understand a health concern affecting the mother or baby. Not all scans involve the same type of exposure. Ultrasound does not use ionising radiation, while X-rays and CT scans do. MRI also does not use ionising radiation. The safest imaging choice depends on the medical question, stage of pregnancy and whether the expected benefit of the test outweighs any potential risk.

Is an X-Ray Safe During Pregnancy?

An X-ray during pregnancy may be performed when there is a clear medical reason for the examination. Most diagnostic X-rays use relatively low levels of ionising radiation, and the amount of radiation reaching the fetus varies considerably depending on which part of the body is being examined.

For example, an X-ray of the teeth, chest or an arm or leg generally exposes the uterus to much less radiation than imaging performed directly over the abdomen or pelvis.

Doctors consider several factors before recommending an X-ray during pregnancy, including:

the medical condition being investigated
the body area that needs imaging
whether another test can answer the same question
the urgency of diagnosis
the stage of pregnancy
the type of imaging equipment and technique required

When an X-ray is medically necessary, the radiology team uses imaging techniques intended to obtain the required diagnostic information while keeping exposure as low as reasonably achievable.

Routine abdominal shielding is no longer universally recommended for all modern X-ray examinations because shielding can sometimes interfere with the image or the equipment’s automatic exposure controls. The radiology team will follow the appropriate protocol for the specific examination.

Pregnant women should always tell the doctor and radiology team that they are pregnant, or may be pregnant, before an examination involving ionising radiation.

For more detail on this specific question, this guide takes a closer look at X-ray safety during pregnancy.

Is an MRI Safe During Pregnancy?

MRI uses a strong magnetic field and radiofrequency energy to create detailed images. Unlike X-rays and CT scans, MRI does not use ionising radiation.

MRI may therefore be considered during pregnancy when detailed imaging is required and ultrasound does not provide enough information. The decision is based on the medical need for the scan and whether the result is likely to affect care.

MRI can be useful for evaluating certain maternal conditions and, in selected situations, for obtaining additional information about fetal development.

However, MRI is still used thoughtfully during pregnancy rather than performed unnecessarily.

Contrast material is an additional consideration. Gadolinium-based contrast agents are generally avoided during pregnancy unless there is a specific clinical reason why contrast is considered necessary and the expected benefit outweighs the potential risk.

If an MRI has been recommended, inform the radiology team about the pregnancy before the scan so that the examination can be planned appropriately.

How Doctors Decide Which Imaging Is Safe to Use

The choice of radiology during pregnancy is based on the clinical question that needs to be answered.

Ultrasound is commonly used during pregnancy because it does not involve ionising radiation and provides valuable information about fetal growth, anatomy and pregnancy-related conditions. It is generally the first-line imaging method for many obstetric questions.

Parents who want to understand its role throughout pregnancy can read more about when and why ultrasound scans are performed during pregnancy.

MRI may be considered when ultrasound does not provide sufficient information or when more detailed imaging of certain tissues is required.

X-rays may be necessary to diagnose conditions such as fractures, dental problems or certain chest conditions. The medical team considers the area being examined and expected fetal exposure before proceeding.

CT scans also use ionising radiation but may be required when rapid and detailed imaging is important, particularly in urgent maternal medical situations. A medically necessary CT examination should not automatically be delayed simply because a patient is pregnant.

The decision is therefore not based on whether an imaging technique is simply “safe” or “unsafe.” Doctors weigh the expected diagnostic benefit against potential risk and choose the examination most likely to provide the information needed with appropriate precautions.

If You’ve Already Had an X-Ray or Scan Before Knowing You Were Pregnant

Finding out that you were pregnant after having an X-ray or CT scan can cause considerable anxiety.

In many situations, diagnostic imaging performed before a woman knows she is pregnant involves a relatively low fetal radiation exposure, particularly when the abdomen or pelvis was not directly examined. Having had an X-ray does not automatically mean that the pregnancy has been harmed.

The most useful next step is to tell your obstetrician or radiologist:

what examination was performed
which part of the body was imaged
approximately when the examination occurred
whether more than one examination was performed
the estimated stage of pregnancy at the time

If necessary, the radiology team can review the examination and estimate the likely fetal exposure rather than relying on assumptions or internet-based risk estimates.

Do not make decisions about the pregnancy based solely on the fact that an imaging examination occurred.

The timing of exposure, type of scan and amount of radiation all matter, and these need to be assessed in the context of the individual examination.

FAQs on Safe Imaging During Pregnancy

Should I have a CT scan if I might be pregnant?

Tell the doctor and radiology team if pregnancy is possible before the scan. CT uses ionising radiation, so the need for imaging, body area and alternative tests will be considered. If a CT scan is medically necessary, particularly in an urgent situation, the benefit of obtaining an accurate diagnosis may outweigh the potential radiation risk.

I was exposed to radiation while pregnant and I'm scared. What should I do?

Do not assume that an X-ray or scan has harmed the pregnancy. Contact your obstetrician or radiologist with details of the examination and when it occurred. They can assess the body area imaged, stage of pregnancy and likely exposure and advise whether any further evaluation is needed.

Is ultrasound completely safe during pregnancy?

Ultrasound does not use ionising radiation and has a long history of use in pregnancy. It is generally considered appropriate when performed for a medical reason by trained professionals. Ultrasound exposure should still be limited to what is necessary to obtain the required clinical information rather than used unnecessarily.

Can I have an MRI while pregnant?

MRI may be performed during pregnancy when there is a clear medical reason because it does not use ionising radiation. The radiologist and treating doctor will consider whether the information is needed and whether ultrasound could answer the same question. Gadolinium contrast is generally avoided unless specifically necessary.

What imaging is avoided during pregnancy unless truly necessary?

Imaging that uses ionising radiation, particularly CT or X-ray examinations involving the abdomen or pelvis, is generally considered carefully and used when the expected medical benefit justifies it. This does not mean these tests are prohibited. Delaying necessary imaging can also carry risks when an important maternal condition needs diagnosis.